Trump Holds Prescription Drug-Pricing Order In Search Of Deal It's been two weeks since the president signed an executive order to put "America First" on drug prices. But pharmaceutical companies aren't ready to negotiate.

'All Bark And No Bite': Trump Holds Prescription Drug-Pricing Order In Search Of Deal

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All right. So the list of norms busted by President Trump is pretty long, but this is a new one. Last month, he signed an executive order related to prescription drug prices, but now he's holding it back while trying to make a deal with drug companies. As NPR White House correspondent Tamara Keith reports, so far, there is little sign the president is getting what he wants.

TAMARA KEITH, BYLINE: President Trump had American flags and women in white lab coats behind him, his big presidential Sharpie marker in hand.


PRESIDENT DONALD TRUMP: ...Favorite Nations.

KEITH: The executive order signed, Trump held it up for the cameras. It was the fourth order he signed that day. Language for the other three was posted online quickly and published in the Federal Register. But the fourth order, titled Lowering Drug Prices by Putting America First, remains something of a mystery. The basic idea is that for drugs administered in a doctor's office or hospital setting, Medicare would start paying the lowest price in the world.


TRUMP: And no more will we have to suffer by saying, gee, why is it so much cheaper for the exact same drug in some other country?

KEITH: But first, Trump said he was going to give drug companies a chance to come up with a better idea.


TRUMP: The order - No. 4, Favorite Nations - a big order - they're all big. All four are very big, by the way - very big. But the fourth order, we're going to hold that until August 24.

KEITH: This isn't how it normally works. Tara Leigh Grove is a professor of constitutional law at the University of Alabama.

TARA LEIGH GROVE: I can't think of any case where the president has signed an executive order publicly and then not put it in the Federal Register.

KEITH: Grove says the process for executive orders varies by administration. But publishing the order is the one big step no one skips because that's what makes it real.

GROVE: Usually if a president is going to issue an executive order, the president wants the people who are supposed to abide by the executive order know what they're supposed to do. And you can't really know what you're supposed to do if they don't tell you.

KEITH: Asked what's in the executive order or how it would achieve what Trump is promising, the White House just directs back to a vague fact sheet and the president's remarks. So Lori Reilly, the COO at PhRMA, the pharmaceutical industry trade group, says they zoomed in on a picture of Trump holding up the executive order to try to see what was in the text.

LORI REILLY: There is a AP picture where there is some language that we were able to see some. But there's a page missing. And - so that leaves questions.

KEITH: If holding back the executive order is a leverage play, it's not clear it's working. Reilly says the industry would be willing to talk about other ways of bringing down drug prices. But this proposal, as they understand it, is a non-starter. In an earnings call, the CEO of Pfizer said he didn't see much need for a White House meeting. Multiple sources say some quiet conversations are happening now. But Trump has been talking about variations on this idea for nearly two years.

CHRIS MEEKINS: The Trump administration is all bark, no bite on drug pricing. And despite the barks getting louder with executive orders, the bite is no harder.

KEITH: Chris Meekins is director of Washington health care policy at Raymond James Financial, and he served in the Department of Health and Human Services in the first two years of the Trump administration. He says there's clearly a reelection motive here. Trump and his campaign want to be able to say they've done something on drug prices.

MEEKINS: It's just more noise. I describe it to clients as Trump on drug pricing feels a little bit like Charlie Brown, Lucy and the football.

KEITH: Even if Trump moves forward with the executive order, that would just mark the beginning of what would likely be a lengthy process that could be further stalled or halted altogether by drug industry lawsuits.

Tamara Keith, NPR News.


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